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Lecture 6

Gingival Conditions and Adjuncts

Periodontology The clinical science that deals with the periodontium in health and disease; that branch of dentistry concerned with etiology, diagnosis, and treatment of diseases of the supporting structures of the teeth
Periodontal ligament Connective tissue fibers that connect the root of the tooth to the alveolus. It contains blood vessels, lymph vessels and nerves.
Periodontium A collective term for the tissues that surround and support the teeth: gingiva, cementum, periodontal ligament, and alveolar bone
alveolar bone Bone that surrounds the teeth
gingiva That portion of the masticatory mucosa which is attached to the teeth and alveolar process and surrounds the cervical area of the teeth
cementum Calcified connective tissue that covers the anatomic root of a tooth. It provides attachment for the periodontal ligament
Periodontics That aspect of clinical dentistry involved in the prevention and treatment of diseases of the periodontium
Oral mucosa Alveolar mucosa Loosely attached tissue such as the tissue from the mucogingival junction to the vestibular epithelium
Periodontal Disease Any abnormality or pathologic state involving the gingiva or supporting tissues of the teeth, commonly used to designate collectively the inflammatory and degenerative diseases of the periodontium
Purposes of periodontal charting Establish baseline data, aid in diagnosis, aid in treatment planning, aid in implementation of treatment plan, evaluate success, and legal / forensic reasons
Terms for extent localized = one or a few teeth generalized = throughout the sextant, arch or mouth
Terms for degree of distribution Marginal = confined to the free or marginal tissue Papillary = involving the papilla Diffuse = attached and free gingiva are involved; usually localized
Normal color uniformly pale pink or coral pink; melanin pigmentation
Abnormal color pink to whitish pink = fibrotic response red = acute inflammation, heavy bleeding bluish red to purple = chronic inflammation, cyanosis, bleeding
Normal marginal contour knife-like, adhere closely to the tooth, follows the contour of the CEJ
Normal papilla contour pointed, triangular, fills embrasure space, diastema- flat and saddle shaped (this is normal)
Normal attached gingiva contour adequate zone is 1-9mm, follows contour of underlying alveolar bone
Abnormal marginal contour rounded > rolled (lifesaver) > McCalls festoon (exaggerated rolling effect) > clefting - Stillmans (slit like recession)
Abnormal papillary contour enlarged > bulbous > blunted > cratered
Abnormal attached gingiva contour mucogingival involvement = no attached gingiva
Normal papillary consistency (tone) papillary firm and resilient when palpated with probe
Normal marginal consistency (tone) marginal smooth, fits snugly to tooth, resists displacement with air
Normal attached gingiva consistency (tone) attached gingiva firmly bound to underlying bone and stippled
Abnormal consistency edematous response soft, spongy, puffy, friable, shiny, glossy, easily displaced with air
Abnormal consistency fibrotic response firm, hard, leathery, nodular
SBI and PCR formula number of areas of bleeding/plaque over the number of teeth times 4 = %
signs of inflammation heat, redness, pain, swelling, loss of function
Time of reassessment In school, the reassessment is done at the beginning of the last appointment in the series of patient appointments
Created by: schubring